This review is based in part on Dr Hart’s lecture at the RCPE Symposium on Neurology in Edinburgh on 16 November 2011.Experience from the clinic suggests that many people equate the term ‘epilepsy’ with the occurrence of convulsions, with the corollary that attacks involving shaking are likely to be due to epilepsy. However, just as many seizure types do not involve shaking, the differential diagnosis of intermittent shaking is wide and includes vasovagal syncope, cardiac disorders, concussive convulsions, psychogenic non-epileptic seizures, ‘shaking transient ischaemic attacks’, parasomnias, breath-holding attacks in children, hypoglycaemia and movement disorders.
